Relationship-based intervention for children who were prenatally alcohol exposed in South Africa

Wendy O Kalberg; Anna-Susan Marais; Marlene M De Vries; Marci Laurel; Kathleen Taylor; Julie M Hasken; Barbara G Tabachnick; David Buckley; Marian A Ortega; Soraya Seedat; Philip A May

doi:10.1016/j.ridd.2023.104479

Relationship-based intervention for children who were prenatally alcohol exposed in South Africa

Res Dev Disabil. 2023 May:136:104479. doi: 10.1016/j.ridd.2023.104479. Epub 2023 Mar 22.

Authors

Affiliations

¹ The University of New Mexico, Center on Alcohol, Substance Abuse and Addictions, 2650 Yale Blvd. SE, Albuquerque, NM, USA.
² Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa.
³ The University of New Mexico, Center for Development and Disability, 2300 Menaul Blvd. NE, Albuquerque, NM, USA.
⁴ The University of New Mexico, Occupational Therapy Department, 2500 Marble Ave. NE, Albuquerque, NM, USA.
⁵ The University of North Carolina at Chapel Hill, Nutrition Research Institute, 500 Laureate Way, Kannapolis, NC 28081, USA.
⁶ California State University, 1811 Nordhoff Street, Northridge, CA 91330, USA.
⁷ The University of New Mexico, Center on Alcohol, Substance Abuse and Addictions, 2650 Yale Blvd. SE, Albuquerque, NM, USA; Faculty of Medicine and Health Sciences, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; The University of North Carolina at Chapel Hill, Nutrition Research Institute, 500 Laureate Way, Kannapolis, NC 28081, USA. Electronic address: philip_may@unc.edu.

PMID: 36963311
PMCID: PMC10103540 (available on 2024-05-01)
DOI: 10.1016/j.ridd.2023.104479

Abstract

Background: This early intervention study investigated the effectiveness of a relationship-based, developmental enhancement process for children who were prenatally exposed to alcohol in the South African context.

Methods: Groups were created according to the child's level of risk for alcohol-related developmental issues based on each mother's alcohol use during pregnancy as assessed using the Alcohol Use Disorders Identification Test (AUDIT). Primary caregiver/child dyads were the focus of the intervention and child development was monitored by the Ages and Stages Questionnaire (ASQ). Eighteen caregiver/child dyads were in the heavily alcohol-exposed group, and 20 caregiver/child dyads were in the no or light alcohol-exposure group. The Home Observation Measurement of the Environment (HOME) was measured pre and post intervention.

Results: The results indicated significant improvements in the home environment (p < .001) post-intervention for the entire cohort. For the total HOME score, there was a statistically significant main effect for time (pre- vs post-test), F(1, 36)= 65.205, p < .001, partial η² = .64. with 99% confidence limits from .35 to .78. The offspring and parents from both the heavy alcohol exposure group and the no/low alcohol exposure group benefitted from the intervention over the duration of the intervention. Of the HOME domains affected, responsivity was the most improved in the households. The children's scores on the ASQ varied substantially over the months of the intervention, and the offspring of the heavy exposure group often performed significantly worse than the no/low exposure group. Nevertheless, further analysis revealed that children with the lowest performance at baseline improved their performance on most ASQ domains throughout the intervention and performed significantly better on all ASQ domains over time and at completion of the intervention.

Conclusions: This relationship-based, early intervention program for children resulted in benefits to all of the children over time.

Keywords: Early Childhood; Early Intervention; Fetal Alcohol Spectrum Disorders (FASD); South Africa.

MeSH terms

Alcohol Drinking / adverse effects
Alcohol Drinking / prevention & control
Alcoholism*
Child
Child Development
Ethanol
Female
Fetal Alcohol Spectrum Disorders* / prevention & control
Humans
Pregnancy
South Africa

Substances

Ethanol

Grants and funding

R01 AA015134/AA/NIAAA NIH HHS/United States